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目的探讨尿道黏膜表面麻醉下铥激光治疗高龄高风险浅表型膀胱肿瘤的手术方法及其可行性。方法在尿道黏膜表面麻醉下,联合窄谱成像技术,用铥激光对17例高龄高危的浅表性膀胱肿瘤实施整块剜除。17例膀胱肿瘤中有男性4例,其中1例行两次手术;女性12例。肿瘤直径0.3~2.0cm,均带蒂,单发肿瘤13例,多发肿瘤4例。结果术中患者耐受良好,无明显活动性出血,未发生闭孔神经反射,无膀胱穿孔、尿外渗。术后病理均为尿路上皮癌,随访3~17月,复发1例。结论在尿道黏膜表面麻醉下,利用铥激光治疗高龄高危浅表性膀胱肿瘤的方法是可行的。
Objective To investigate the surgical methods and feasibility of urethral mucosal surface anesthesia with 铥 laser treatment of elderly high-risk superficial bladder tumors. Methods Under urethral mucosal surface anesthesia, combined with narrow-band imaging technique, 17 cases of high-risk superficial bladder tumors were treated with 铥 laser. There were 4 males in 17 cases of bladder tumors, of which 1 case underwent two surgeries and 12 females. Tumor diameter 0.3 ~ 2.0cm, pedunculated, single tumor in 13 cases, multiple tumors in 4 cases. Results Intraoperative patients were well tolerated, no active bleeding, no obturator nerve reflex, no bladder perforation, and extravasation of urine. Postoperative pathological urothelial carcinoma were followed up for 3 to 17 months, 1 case of recurrence. Conclusion Under urethral mucosal surface anesthesia, it is feasible to use 铥 laser to treat elderly patients with high risk of superficial bladder tumor.